Individuals born to a mother with
elevated LDL cholesterol levels are nearly four times more likely than those
born to a mother with normal cholesterol levels to have dyslipidemia, according
to a new analysis of the Framingham Heart Study (FHS).

In 241 parent-offspring pairs,
mean adult LDL cholesterol levels were 18 mg/dL higher among those exposed to
elevated maternal pre-pregnancy LDL cholesterol levels than those born to
mothers with normal cholesterol.

Writing in the latest cardiology
journal to hit the medical stacks, JAMA:
Cardiology, Mark Mendelson, MD (National Institutes of Health, Framingham,
MA), and colleagues report that the association between elevated LDL
cholesterol in women prior to the birth of the child and the elevated risk of
dyslipidemia in their adult offspring remained even after adjusting for
lifestyle, body mass index, and inherited genetic variants known to be linked
with elevated LDL cholesterol levels.

In the mother-offspring pairings, each 10-mg/dL increase in the mother’s
pre-pregnancy LDL cholesterol levels was associated with a 3.2-mg/dL increase
in the offspring’s LDL cholesterol. For 297 father-offspring pairs, each
10-mg/dL increase in pre-pregnancy LDL cholesterol levels was associated with a
1.3 mg/dL increase in the offspring’s LDL cholesterol. In contrast with the
mothers, the association between LDL cholesterol levels in the adult offspring
and the father’s LDL cholesterol level was not statistically significant after
adjusting for confounding variables, such as lifestyle and an LDL cholesterol
genetic risk score.

Pre-pregnancy LDL cholesterol in the mother’s explained 13% of the
variation in the adult offspring LDL cholesterol levels, according to the
investigators.

“An improved understanding of the CVD risk associated with the
intrauterine environment may inform population-based lifestyle strategies for women
in their childbearing years to identify those at risk and to direct lipid-specific
nutritional and lifestyle interventions or therapeutics,” conclude the
researchers.

Marc Sabatine, MD (Brigham and Women’s Hospital, Boston, MA), who wrote
an editor’s note to accompany the study, agreed with researchers, noting that
an association does not imply causality. He also added the analysis is based on
data from the FHS Offspring story, where the mother’s dietary habits might have
played a greater role than the father’s. That said, there is a “growing body of
evidence that epigenetic regulation of gene expression can be influenced by
environmental exposures,” something that will need to be studied further,
according to Sabatine.

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